ATLS Hemorrhage Control and Damage Control Surgery 2

Question 1

To maximize benefit in traumatic hemorrhage, tranexamic acid (TXA) should be administered:

Accepted Answer

Within 3 hours of injury, with the first dose given as early as possible

Answer

Evidence from the CRASH-2 trial shows TXA is most effective within 3 hours of injury; benefit decreases with time and may be harmful if given after 3 hours.

Question 2

Which hemostatic dressing is recommended by ATLS guidelines for uncontrolled external extremity hemorrhage not amenable to tourniquet?

Accepted Answer

Combat gauze (kaolin-impregnated) or similar zeolite/chitosan-based hemostatic agent

Answer

ATLS recommends hemostatic dressings such as kaolin-impregnated combat gauze or chitosan-based products packed firmly into wounds that cannot be controlled with a tourniquet.

Question 3

A patient with an unstable pelvic ring fracture and hemodynamic instability should initially receive:

Accepted Answer

Pelvic binder or circumferential sheet wrap for provisional stabilization

Answer

A pelvic binder or sheet wrap reduces pelvic volume, tamponades venous bleeding, and stabilizes the fracture as the critical first step before imaging or surgery.

Question 4

When REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) is placed in Zone 1, it is used to address hemorrhage from:

Accepted Answer

Intra-abdominal and thoracoabdominal hemorrhage above the celiac axis

Answer

Zone 1 REBOA placement (descending thoracic aorta) controls hemorrhage from abdominal solid organs and major vessels by occluding aortic flow above the bleeding site.

Question 5

A tourniquet applied to control extremity hemorrhage should be positioned:

Accepted Answer

2–3 inches proximal to the wound with sufficient pressure to obliterate the distal pulse

Answer

Tourniquets must be placed proximal to the injury and tightened enough to eliminate the distal pulse, ensuring arterial hemorrhage is controlled.

ATLS - Advanced Trauma Life Support Practice Test

ATLS - Advanced Trauma Life Support Practice Test

ATLS Hemorrhage Control and Damage Control Surgery 2